During the COVID-19 era, India, especially states like Bihar and Jharkhand faced severe public health and socio-economic challenges. Both states, characterized by high population density, limited healthcare infrastructure, and significant rural populations, struggled with inadequate testing capacity, shortages of medical oxygen, and insufficient hospital beds during successive waves. Large-scale reverse migration further strained already fragile systems, as returning workers increased the risk of community transmission in rural areas. Additionally, low levels of health awareness, misinformation, and barriers to accessing essential services disproportionately affected women and marginalized communities, leading to disruptions in maternal health services, immunization coverage, and management of chronic illnesses.
This was when CDOT developed and designed the Community Health Facilitator Project, keeping in mind a community-based intervention leveraging trained female Community Health Facilitators (CHFs) working primarily on spreading awareness about preventive health education. This project was approved and supported by IPE Global and USAID for a year (2022). The CHFs conducted door-to-door awareness campaigns on COVID-appropriate behavior, including mask usage, hand hygiene, and vaccination uptake, while also countering misinformation through culturally sensitive communication. The project integrated follow-ups, tele-consultation sessions and coordination with local health systems to ensure continuity of essential services such as antenatal care and immunization. By prioritizing women as frontline educators and trusted community figures, the initiative strengthened last-mile outreach, improved health-seeking behavior, and built community resilience against current and future public health emergencies.
Meanwhile, the CDOT team also wanted to expand to more districts/blocks of Bihar & Jharkhand, so we designed a similar CHF project in early 2022. This project was approved and supported by Opportunity International Australia (OIA) for a period of three years (2022–2025). The CHFs performed similar roles focusing on COVID-19 related initiatives initially, but then moved on to imparting awareness about various other preventive health education modules. Building a cadre of trusted community health leaders also helped us in making them self-sustainable entrepreneurs and women of substance in their respective communities.
The CHF project and the idea behind it was a success as it led to the conception of a multi-country project. During early 2025, the CDOT team designed a fresh high-level project with OIA, based on the CHF model itself. This project was approved and supported by Global Affairs Canada (GAC) for a period of 5 years (2025–2030). The aforementioned project was titled WE CARE: Women Empowered through Community and Resilience-Enhancing Health Systems, and is currently being implemented by CDOT.
Women Empowered through Community and Resilience-Enhancing Health Systems (WE CARE) is a transformative, community-based public health initiative designed to address critical gaps in primary healthcare access, gender equity, and health awareness in the underserved districts of Bihar and Jharkhand, India. Anchored in a model of women-led service delivery, the project will be implemented over a five-year period (2025–2030) by CDOT (Centre for Development Orientation and Training) — a trusted grassroots development organization with extensive experience in community health facilitation and gender-based programming.
The WE CARE initiative builds on CDOT’s earlier success with the Community Health Facilitator (CHF) model and now introduces a more scalable and systems-oriented approach — empowering 350 trained female Community Health Workers (CHWs) to deliver primary health services, health education, referrals, and health-related products within their own communities.
The purpose of the WE CARE project is to improve health outcomes, foster preventive health-seeking behavior, and strengthen the resilience of vulnerable communities — particularly women, adolescent girls, people with disabilities, and marginalized caste and tribal groups — by delivering quality, doorstep health services through a sustainable and scalable community health system. Through integrated service delivery, digital health tools, gender-sensitive programming, and livelihood opportunities for CHWs, the project envisions a locally led, resilient healthcare ecosystem that is accessible, inclusive, and future-ready.
WE CARE will be implemented across two states in eastern India — Bihar and Jharkhand — which consistently report some of the country’s poorest health indicators, highest poverty rates, and widest gender-based disparities in access to healthcare.
4 districts in Bihar:
Expansion to 6 additional districts:
CDOT is responsible for all aspects of implementation in India: CHW recruitment and training, community engagement, digital integration, stakeholder coordination, and Results-Based Management (RBM) reporting.
The WE CARE project aligns fully with the Feminist International Assistance Policy (FIAP) and sectoral priorities of Global Affairs Canada (GAC), including:
By empowering women CHWs to become healthcare providers, educators, and entrepreneurs, WE CARE advances GAC’s commitment to local leadership, systemic transformation, and equity-driven development.
The WE CARE project is designed to reach 3.2 million people over five years, through a combination of direct and indirect engagement strategies.
Through the Community Health Facilitator Project, supported by Opportunity International Australia, we covered over 110,000 households and reached 5.5 lakh people with the help of our 450 CHFs in the past 3 years (2022–2025).
Apart from door-to-door orientation on various modules related to preventive healthcare, our CHFs also:
Aarti Devi, a young and enthusiastic health facilitator from Dariyapur block in Patna, has been associated with CDOT’s CHF project since August 2023. She has four children and her husband works as a daily-wage labourer. She is loved most for her contribution in helping people with vital check-ups, but what makes her different from others is her sensitivity and approach towards gender equity after she was exposed to GEDSI (Gender, Equality, Disability & Social Inclusion) training from CDOT.
“The GEDSI training was something that impacted me more than anything else. People never talk about these things and after I was informed, I decided that I will help people from the transgender or intersex community who have a variation in their sexual or reproductive anatomy, because I witnessed my neighbour face challenges and discrimination for the same. GEDSI training gave me knowledge on how I could sensitize people on sexual choices or gender identity. I try to talk about the reality of the transgender community and the stigma they face. My belief is that people from the transgender community are the same as everyone else and all they want from life is to be de-stigmatised, happy, and most importantly, to be respected.” — Aarti Devi
